“Most of the spine has stabilizing elements that don’t contain synovium, but the first two vertebra in the neck — also called the cervical spine — are synovial, which means they’re more mobile and are more susceptible to damage,” explained Susan Goodman, MD, a rheumatologist at Hospital for Special Surgery in New York City. Joint destruction can make the spine unstable, leaving the spinal cord — the bundle of nerves traveling from the brain — unprotected, she said.

Dr. Goodman explained that, in people who’ve had RA for a long time, spinal cord involvement can be missed. These people often already have mobility problems because of problems with hips, knees, and other large joints, so pressure on the spinal cord is not always detected.

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Symptoms of Spinal Cord Syndrome

Goodman said that sometimes symptoms are hard to pin down, but headaches, pain in the arms, and an unstable gait could be telltale signs.

RA often affects the cervical spine early in the disease, making it especially important to get good RA control right away to decrease the chances of developing complications like spinal cord syndrome, Goodman said. Today, early treatment with biologic drugs can help prevent RA from getting worse.